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Leading the way in e Health 25 th May,2010

Leading the way in e Health 25 th May,2010. E Health Innovation. REFERENCE NUMBER. The current challenge?. Three key questions…. Can we ride the perfect storm? Financial challenge.. People challenge.. Ageing population.. Where should we aim? Point or whole system?

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Leading the way in e Health 25 th May,2010

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  1. Leading the way in e Health25th May,2010 E Health Innovation REFERENCE NUMBER

  2. The current challenge?

  3. Three key questions… • Can we ride the perfect storm? • Financial challenge.. • People challenge.. • Ageing population.. • Where should we aim? • Point or whole system? • How innovative can we be? • Disruptive or play safe?

  4. A major challenge for Scotland-24%more beds by 2016, 84% by 2031 84% 61% 41% 24% 9% P Knight Scottish Government Calendar year ’07 estimate NHS Tayside +148 beds 2016 +517 beds 2031

  5. Compelling areas for improvement..T12 Compelling challenge, local variation?

  6. Our approach?

  7. Steps to Better Healthcare- a whole systems approach.. Elective Urgent & Emergency Community Care Services Improve efficiency for all 36 Outpatient Clinics . Medicine for the Elderly Integrated Care (Virtual Ward) Deliver proactive care management via combined model Mental Health Prescribing Reducing wastes and cost in prescribing Business Support Unit

  8. A whole system challenge, typical NHS board.. Direct Access Direct Access 15,881 Discharged 55,464 (73%) IP Admission A&E Inpatients A&E Attends 10,631 (14%) Total U&E IP Admission 75,979 44,242 (28,361) Acute R/C Admission 9,877 (13%) Acute Patient Non Elective ~ £86M Virtual Ward savings 3% ~ £2.5m pa 5% ~ £ 4.3m pa 10% ~ £8.6m pa SGHD HEAT T6, T8, T10 , T12 Acute Attends 26,077 38% Acute Wards GP/other Refer IP Admission 16,200 17,730 (68%) 62% Other Care Discharged 547(2%) 7,800(30%)

  9. HEAT T12 Doing the right things.. Triple Aim There is objective evidence that the Board is able to track progress against key targets and perform well at a tactical level Integrated Resource Framework Corp 3 HEAT 2 HEAT 1 HEAT 3 HEAT 2 HEAT 1 HEAT Corp 1 Corp 2 HEAT HEAT T10 HEAT T8 HEAT T6

  10. Who are the whole system stakeholders?

  11. Triple Aim – LTC Whole Care Continuum Art of the probable? What do you See? • T12 Emergency Bed Days over 65’s • T6 Long Term Conditions admissions • Patient experience • Community team effective patient facing time • Medication Concurrence Tayside Community Today What now? Make it real! ‘Test of Change’ Demonstrators Tayside Community Tomorrow Desire Learn Adopt What do you Want? We are here 26/05/10 Prioritise Align Outcome based response Benefits Realisation Truly needs Based! Our Future Impact Assessment Acute Patient Non Elective ~ £86M Virtual Ward savings 3% ~ £2.5m pa 5% ~ £ 4.3m pa 10% ~ £8.6m pa SGHD HEAT T6, T8, T10 , T12 VIRTUAL WARD AIMS TO DELIVER £2.0-2.5M RECURRING SAVINGS

  12. Multi-disciplinary stakeholder engagement / outcome • E Health • Service Improvement • Senior Management reps • Social Care • Telehealth / Telecare reps • Mental Health Professionals • Secondary Care – Ward • Community Hospitals • A&E • Patients • Carers • Voluntary organisations • Care Home representatives • Home Care representatives • Community/Practice Pharmacists • GP’s cross section • Practice Managers • Specialist Nurses • District Nurses • Allied Health Professionals OUTCOMES • Agreed Predictive Modelling was key • E Health was a key enabler • Local stakeholder engagement key • Learn from best practice • Local • National • UK/Global wide

  13. Triple Aim – LTC Whole Care Continuum Macro Integrator NHS Tayside and Councils LEVELS OF CARE 0 0.5% LEVEL 5 HIGHLY COMPLEX CO-MORBIDITY 816 LEVEL 4 COMPLEX CO-MORBIDITY VIRTUAL WARD ANTICIPATORY CARE PLANS PATIENT PASSPORTS CASE MANAGEMENT 0.5% 5.0% LEVEL 4 COMPLEX CO-MORBIDITY 8163 LEVEL 3 SUPPORTED SELF CARE CO-MORBIDITY 5.0% 20.0% LEVEL 3 SUPPORTED SELF CARE CO-MORBIDITY LEVEL 3 SUPPORTED SELF CARE CO-MORBIDITY CHD 19341 20.0% 80.0% LEVEL 2 SUPPORTED SELF CARE SINGLE LTC COPD 8795 LEVEL 1/2 SUPPORTED SELF CARE SINGLE LTC HBP 56918 Diabetes 15808 Asthma 22935 80.0% 100.0% LEVEL 1 PREVENTION WELLBEING LEVEL 1 PREVENTION WELLBEING Long Term Conditions PREDICTED RISK PROFILE MICRO INTEGRATORS

  14. Typical Integrated Care Model Next Future State Identify Cases Initiate Case Management Care Assessment & Planning Care Delivery & Review Service Menu Initial LTC Referral PEONY Combined Model Assess Produce Anticipatory Care Plan Patient Passport Receive & Capture Referral Allocate Case Manager Single Point of Access 7*24 Diagnostic Intervention Unplanned Referral SKILLS MIX PLANNING Patient, Carer, Professional Info request Review And Assess Update patient Record with ACP/PP Elective Referral Update patient record Update patient record Generate Referrals Urgent Intervention Integrated Care Case Finding Service Case Finding Planned Intervention Integrated Care e Health infrastructure

  15. Perth & Kinross Virtual WardTest of Change’ demonstrator • Local Profiles • Total Population – 11,123 • 65+ – 2,525 • Under 65 – 8,598 • (GRO Scotland 2006)

  16. E Health opportunity

  17. User Device Access Applications Integrated Care – information architecture Security Service Virtual Wards Collaboration Glue Staff ID Clinical Portal Case Management Virtual Database RBAC PMS GP Community Health& Social TELEHEALTH Health Coaching TELECARE PREDICTIVE RISK BUSINESS ANALYTICS Prevention Service Directory Integration Platform

  18. E Health success E Pharmacy

  19. ePharmacy Progress and benefits to patients throughout Scotland Minor Ailments Service (eMAS) • Live nationally in June 2006 used by 800,000 patients • All pharmacies able to register patients on national database and issue prescriptions • All reimbursement claims electronic. Acute Medication Service (eAMS) • Live nationally in July 2009 used by every person who visits a GP practice or Pharmacy • 900,000 prescriptions per week processed (95% of total) • First full end-to-end UK ETP solution • Increased efficiencies in Prescription processing • Patient Safety benefits (Emergency Care Summary) • All GP Practices, pharmacies and NSS connected Chronic Medication Service (eCMS) • Infrastructure live May 2009, national roll out Q1 2010 • First GP and Pharmacy sites in early adopter phase – NHS Fife • Allows GPs to issue six or 12 month prescriptions • Reduction in patient visits, reduced costs • Dispensing information back to GP Practice • Medicines management savings

  20. CP System GP System ePharmacy Core Infrastructure NSS PSD ~ Atos Origin CHI GP (1000) Information Services Division Patient Registration Service A ePharmacy Message Store Elec msgs via N3 network Payment process Pharmacy (1200) ePay rules engine A Scanning and message processing Forms sent to PSD

  21. Rx Rx Rx Rx Rx Rx Rx Rx Rx GP GP PMR PMR ePMS ePMS ePMS ePharmacy Electronic Transfer of Prescriptions Process Barcoded prescription form(s) produced Prescription form(s) received at pharmacy Electronic messages sent to ePMS Barcodes Scanned Issue medication and submit claim Pharmacy system uses elec datato support Electronic message sent & result received Paper form Elec Msg

  22. Key focus areas?

  23. Key Focus Areas? • Collaboration • Supporting the whole system • Extended health and social care networks • D2D business • Supporting people living with Long Term Conditions • Older People’s Services • Scotland’s economy • Business Analytics • Performance Management • Communication • HEAT Targets / Quality Strategy in Scotland • In England? QIPP ??

  24. For more information please contact: Iain Anderson07805-910568iain.anderson@atosorigin.com

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